Department of Pediatrics, University Children's Hospital Rostock, Ernst-Heydemann-Str. 8, Rostock, Germany.
Ann Clin Biochem. 2012 Nov;49(Pt 6):546-53. doi: 10.1258/acb.2012.011274. Epub 2012 Sep 14.
Paediatric reference values for novel markers of phosphate homeostasis, bone formation and resorption and their putative relationship to growth are lacking.
A total of 424 healthy children, adolescents and young adults (221 males) aged 0.1-21 y, were enrolled in this cross-sectional study. Height, weight and height velocity were assessed. Plasma/serum samples for determination of C-terminal fragment of fibroblast growth factor-23 (cFGF-23), sclerostin, bone alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase 5b (TRAP5b) were available from 222, 264, 352 and 338 individuals, respectively. Calculation of cross-sectional centiles and z-scores was based on median (M), standard coefficient of variation (S) and the Box-Cox power (L) of transformation (LMS method) per age cohort. Correlations between variables as well as with growth were assessed.
cFGF-23, BAP and TRAP5b were significantly correlated with age (each P < 0.01), with highest values during infancy and adolescence. Serum levels of BAP and TRAP5b were significantly higher in adolescent boys compared with girls (each P < 0.01). In contrast, sclerostin levels were independent of age and gender. BAP and TRAP5b were strongly correlated and both were significantly associated with cFGF-23 and sclerostin as well (each P < 0.01). cFGF-23 was positively correlated with serum phosphate and renal phosphate threshold concentration (each P < 0.01). Height, weight, body mass index and height velocity were weakly correlated with BAP and TRAP5b (each P < 0.05).
This study provides age- and gender-related centile charts and z-scores for cFGF-23, BAP, TRAP5b and sclerostin and highlights the link between phosphate homeostasis and markers of bone metabolism during growth.
目前缺乏儿童期新型磷酸盐稳态标志物、骨形成和吸收及其与生长的潜在关系的参考值。
本横断面研究共纳入 424 名健康儿童、青少年和青年（男 221 名），年龄 0.1-21 岁。评估身高、体重和身高增长速度。222、264、352 和 338 名个体分别有血浆/血清样本用于测定纤维母细胞生长因子 23 羧基端片段（cFGF-23）、硬化蛋白、骨碱性磷酸酶（BAP）和抗酒石酸酸性磷酸酶 5b（TRAP5b）。基于每个年龄组的中位数（M）、标准变异系数（S）和转换的 Box-Cox 幂（L）（LMS 法）计算了横断面百分位数和 Z 评分。评估了变量之间以及与生长之间的相关性。
cFGF-23、BAP 和 TRAP5b 与年龄显著相关（P 均<0.01），婴儿期和青春期时值最高。青春期男孩的血清 BAP 和 TRAP5b 水平明显高于女孩（P 均<0.01）。相比之下，硬化蛋白水平与年龄和性别无关。BAP 和 TRAP5b 显著相关，与 cFGF-23 和硬化蛋白也显著相关（P 均<0.01）。cFGF-23 与血清磷酸盐和肾磷酸盐阈浓度呈正相关（P 均<0.01）。身高、体重、体重指数和身高增长速度与 BAP 和 TRAP5b 呈弱相关（P 均<0.05）。
本研究提供了 cFGF-23、BAP、TRAP5b 和硬化蛋白与年龄和性别相关的百分位数图表和 Z 评分，并强调了生长过程中磷酸盐稳态与骨代谢标志物之间的联系。
